Wal-Mart Stores Texas LLC

NPI #1396148193 in Desoto, Texas

Provider Information

NPI Number
1396148193
Entity Type
Organization
Organization Name
Wal-Mart Stores Texas LLC
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Oct 7, 2014
Last Updated
Jun 12, 2025

Practice Location

Address
108 W PARKERVILLE RD
City
Desoto
State
Texas
ZIP Code
75115-8074
Phone
(469) 643-5017

Authorized Official

Name
KIMBERLY CANONIC
Title
SENIOR DIRECTOR, ENROLLMENT
Phone
(480) 853-0515

Specialties & Taxonomy Codes

Specialty
Durable Medical Equipment & Medical Supplies
Pharmacy - Community/Retail PharmacyCommunity/Retail Pharmacy

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